Abstract
The aim of this study was to test the hypothesis that occult tumour cells in peritoneal lavage are a negative prognostic factor in pancreatic adenocarcinoma. Real-time RT-PCR analysis of CEA, EGFR and hTERT transcript levels was used to identify occult tumour cells in peritoneal lavage samples from 96 pancreatic cancer patients. We found significant association between CEA expression levels in peritoneal lavage and clinical stage. We also found that EGFR transcript levels were higher in peritoneal lavage samples from patients with high grade tumours than in samples from patients with low grade tumours. Detection of CEA and/or EGFR occult tumour cell markers in the peritoneal lavage was associated with significantly shorter overall survival and increased hazard ratio for disease recurrence. The results show that the presence of occult tumour cells in peritoneal lavage is a negative prognostic factor for survival in pancreatic cancer patients, and that detection of occult tumour cells using PCR-based methods can identify patients with advanced disease for whom radical surgery is likely to have little benefit.
Highlights
As the most aggressive of all major cancers, pancreatic cancer is a significant medical problem facing current healthcare systems
We found a significant positive association (P
We found that EGFR transcript levels were significantly higher (P
Summary
As the most aggressive of all major cancers, pancreatic cancer is a significant medical problem facing current healthcare systems It has a very poor prognosis, the incidence is increasing and, despite advances in research, the mortality rate is not decreasing[1]. Some authors consider the disease to be systemic from the start and a number of surgeons have rejected or rarely performed radical operations on the pancreas with therapeutic intent[2]. This view is surely overly pessimistic, especially for patients with curable resecTable tumours. It does suggest that pancreatic cancer is highly invasive from the start, due to its localization and aggression
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